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Quantifying the size of the informal care sector for Australian adults with mental illness: caring hours and replacement cost

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Abstract

Purpose

To quantify and value the total informal support provided by family and friends to Australian adults with mental illness in 2018.

Methods

The number of mental health carers was drawn from the 2015 Survey of Disability, Ageing and Carers (SDAC), adjusted to the 2018 population. Annual caring hours by type of assistance were estimated using the SDAC, 2007 National Survey of Mental Health and Wellbeing and an online carer survey. Caring hours for each task were assigned an hourly replacement cost from the National Disability Insurance Scheme. Informal caring was valued as the sum of these costs minus expenditure on carer income support payments, estimating how much it would hypothetically cost governments to replace this care with formal support services.

Results

An estimated 354,000 (95% uncertainty interval (UI): 327,000–383,000) Australian mental health carers provided 186 million (95% UI: 159–215) hours of support in 2018. The estimated replacement cost was AU$8.4 billion (95% UI: 7.0–10.0), excluding AU$1.3 billion in income support. Univariate sensitivity analyses demonstrated that results were robust to variation in model inputs, with total caring hours the most influential parameter. Using an alternative estimate of mean caring hours, the replacement cost could be as high as AU$13.2 billion (95% UI: 11.2–15.4).

Conclusion

Informal carers provide substantial support to people with mental illness, highlighting their important contribution to the mental health system and reinforcing the need for carer support services. Future valuation studies would benefit from refinement of available data collections, particularly on hours and types of care provided.

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Acknowledgements

This paper builds on and updates an earlier replacement cost study conducted by the authors and funded by Mind Australia under the Mind Carer Development Fund; the original project report can be found at: https://www.mindaustralia.org.au/sites/default/files/Mind_value_of_informal_caring_full_report.pdf. The funder provided an advisory group (Frances Sanders, Margaret Grigg, Philip Norman and Gerry Naughtin) to support the original research but otherwise had no direct role in study design, data analysis, interpretation or writing of this paper.

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Authors and Affiliations

  1. School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia

    Sandra Diminic, Yong Yi Lee, Emily Hielscher, Meredith G. Harris & Harvey A. Whiteford

  2. Policy and Epidemiology Group, Queensland Centre for Mental Health Research, The Park-Centre for Mental Health, Locked Bag 500, Archerfield, QLD, 4108, Australia

    Sandra Diminic, Yong Yi Lee, Emily Hielscher, Meredith G. Harris & Harvey A. Whiteford

  3. Deakin Health Economics, Institute for Health Transformation, School for Health and Social Development, Faculty of Health, Deakin University, Geelong, Australia

    Yong Yi Lee

  4. Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia

    Emily Hielscher

  5. Carer Consultant, Gold Coast, Australia

    Jan Kealton

  6. Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA

    Harvey A. Whiteford

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  1. Sandra Diminic
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Correspondence to Sandra Diminic.

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Ethics approval for this study was obtained from The University of Queensland Behavioural and Social Sciences Ethical Review Committee (approval number 2015001907).

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Diminic, S., Lee, Y.Y., Hielscher, E. et al. Quantifying the size of the informal care sector for Australian adults with mental illness: caring hours and replacement cost. Soc Psychiatry Psychiatr Epidemiol 56, 387–400 (2021). https://doi.org/10.1007/s00127-020-01868-y

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